Provider Demographics
NPI:1326847997
Name:GOLDENDEEP SINGH, NO NAME GIVEN (MD)
Entity type:Individual
Prefix:
First Name:NO NAME GIVEN
Middle Name:
Last Name:GOLDENDEEP SINGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:GOLDENDEEP
Other - Middle Name:
Other - Last Name:SINGH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4241 SUSSEX AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-6721
Mailing Address - Country:US
Mailing Address - Phone:618-791-7388
Mailing Address - Fax:
Practice Address - Street 1:50 COURT ST STE 508A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4848
Practice Address - Country:US
Practice Address - Phone:347-602-9530
Practice Address - Fax:949-561-5543
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY327686208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty